Antineoplastics
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Reactions 1494, p9 - 29 Mar 2014 S Antineoplastics Left-sided tubular colonic duplications following maternal exposure: case report A 29-year-old man developed left-sided tubular colonic duplication presenting as an acute abdomen with abdominal compartment syndrome following maternal exposure to antineoplastics [dosages and time to reaction onset not stated]. The man presented with an acute abdomen. He was hospitalised with a 3-day history of abdominal pain. His history revealed that his mother had been treated for 5 years with a protocol consisting of the following antineoplastics: vincristine, prednisolone, asparaginase, mercaptopurine [routes not stated] and intraspinal methotrexate [child’s route of exposure not stated]. This had been followed by radiation treatment and intraspinal cytarabine. She had ended chemotherapy for her acute lymphoblastic leukaemia 2 years before the patient’s birth. The pregnancy had been uneventful. He had a childhood history of a meteoristic abdomen, fecal soiling and chronic constipation. A barium enema had revealed a megacolon, and he had been treated with a rectal enema. In his adolescence and recently, he continued to experience a meteoristic abdomen. After admission, his fever increased. Following an explorative laparoscopy and a laparotomy, an excessively dilated sigmoid colon was observed. He underwent a temporary loop sigmoidostomy for a suspected obstructing rectal cancer of the dilated colon segment, and a washout of the anal stoma was started. He developed abdominal compartment syndrome with respiratory insufficiency within 2 days. Upon acute relaparotomy, the dilated colon was identified as a colonic duplication. In the previous operation, it had been incorrectly interpreted as a tumour. The man underwent a resection of the two inseparable colonic tubes. Resection of the remaining double-shaped colon was performed 4 months later, making an anastomosis from the rectum to the transverse colon. Author comment: "[T]his story may led [sic] to the attention of an association between previous parental chemotherapy and subsequent fetal intestinal duplication. Our case story shows that physicians should consider colonic duplication in adults even when examined in childhood with endoscopy". Oerskov LH, et al. Left-sided tubular colonic duplication presenting as an acute abdomen with compartment syndrome. [Review]. American Surgeon 78: E525-6, No. 12, Dec 2012 - Denmark 803100962 1 Reactions 29 Mar 2014 No. 1494 0114-9954/14/1494-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1494, p9 - 29 Mar 2014
SAntineoplastics
Left-sided tubular colonic duplications followingmaternal exposure: case report
A 29-year-old man developed left-sided tubular colonicduplication presenting as an acute abdomen with abdominalcompartment syndrome following maternal exposure toantineoplastics [dosages and time to reaction onset not stated].
The man presented with an acute abdomen. He washospitalised with a 3-day history of abdominal pain. Hishistory revealed that his mother had been treated for 5 yearswith a protocol consisting of the following antineoplastics:vincristine, prednisolone, asparaginase, mercaptopurine[routes not stated] and intraspinal methotrexate [child’s routeof exposure not stated]. This had been followed by radiationtreatment and intraspinal cytarabine. She had endedchemotherapy for her acute lymphoblastic leukaemia 2 yearsbefore the patient’s birth. The pregnancy had been uneventful.He had a childhood history of a meteoristic abdomen, fecalsoiling and chronic constipation. A barium enema had revealeda megacolon, and he had been treated with a rectal enema. Inhis adolescence and recently, he continued to experience ameteoristic abdomen. After admission, his fever increased.Following an explorative laparoscopy and a laparotomy, anexcessively dilated sigmoid colon was observed. Heunderwent a temporary loop sigmoidostomy for a suspectedobstructing rectal cancer of the dilated colon segment, and awashout of the anal stoma was started. He developedabdominal compartment syndrome with respiratoryinsufficiency within 2 days. Upon acute relaparotomy, thedilated colon was identified as a colonic duplication. In theprevious operation, it had been incorrectly interpreted as atumour.
The man underwent a resection of the two inseparablecolonic tubes. Resection of the remaining double-shapedcolon was performed 4 months later, making an anastomosisfrom the rectum to the transverse colon.
Author comment: "[T]his story may led [sic] to theattention of an association between previous parentalchemotherapy and subsequent fetal intestinal duplication.Our case story shows that physicians should consider colonicduplication in adults even when examined in childhood withendoscopy".Oerskov LH, et al. Left-sided tubular colonic duplication presenting as an acuteabdomen with compartment syndrome. [Review]. American Surgeon 78: E525-6,No. 12, Dec 2012 - Denmark 803100962
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Reactions 29 Mar 2014 No. 14940114-9954/14/1494-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
